Organization
CONCORD PROSTHETICS AND ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS P GRIGORIEFF (OWNER)
(978) 371-1684
Entity
Organization
Contact information
Practice address
801 MAIN ST, SUITE 8, CONCORD, MA 01742-3313
(978) 371-1684
(978) 371-7504
Mailing address
801 MAIN ST, SUITE 8, CONCORD, MA 01742-3313
(978) 371-1684
(978) 371-7504
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151560000
—
ME
05
—
1531484
—
MA
01
—
277754
BLUE CROSS BLUE SHIELD
MA
05
—
30003020
—
NH
01
—
6340
FALLON
MA
01
—
700626
HARVARD PILGRIM
MA
01
—
711116
TUFTS
MA
01
—
96949701
NETWORK HEALTH
MA
Enumeration date
10/25/2007
Last updated
12/17/2007
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